New Hampshire has many QA statutes in RSA 151 and they are essentially the same. In the late 1990s, a law was enacted to protect hospital QA proceedings. After that, many specific providers followed suit – nursing homes, surgery centers, home care, physician practices and even HMOs.
These laws require review committee records to be confidential and privileged. Health care providers may not be held liable for providing information to medical peer review committees. The state’s medical licensing boards have their own medical peer review committees that are meant to protect public health or safety and discipline members. These committees’ information is confidential and privileged as well. No hospital, trustees, medical staff, employees, or other committee attendees are to be held legally liable in any action for damages arising from the providing of information to a hospital committee.
In New Hampshire there is a QA confidentiality statute that applies to specifically to home care. It is RSA 151:13-b. http://www.gencourt.state.nh.us/rsa/html/XI/151/151-13-b.htm. Because hospice providers are licensed under the authority of RSA 151:2-b, the provision applies to them as well. If a prosecuting attorney subpoenas QAPI minutes, you are not obligated to release them.
This statue was designed to allow home care agencies the opportunity to investigate adverse events or explore problem areas and develop plans to resolve them. Once you release the minutes of your QAPI meeting, they are completely discoverable. Only your board of trustees can waive the confidentiality of the QAPI minutes and this should only be done after careful consultation with legal counsel.
There is another statute, 329-29, which is designed specifically intended to address the QA program within a physician practice.
Keep in mind that New Hampshire’s home care licensing rules (He-P 809) require agencies to report “reportable incidents” to the Bureau of Health facilities licensing. See the definition in 809.03. It is very narrow, and relates to the unanticipated death of a patient or abuse and neglect. 809.14 (o) stipulates what needs to reported for these incidents.
It is not clear if these reports are kept confidential by DHHS, so you should be careful not inadvertently release QAPI records with these reports, unless your Board approves after consultation with legal counsel. Also, 809.18 requires that you have a QAPI committee and outlines the standards. You should also look at the Medicare CoP requirements.
A final note. Since I am not a lawyer, none of the above should be considered legal advice. I strongly recommend you consult with your attorney to answer any questions about the applicability of the statutes and rules, and how best to structure your QAPI Committee to address adverse events.